Kevin L. Kraemer, MD, MSc, Associate Professor of Medicine at the University of Pittsburgh is applying for this mid-career investigator award in patient-oriented research (K24). His intermediate career objectives are: 1) to grow as a leader in improving alcohol screening and intervention in various clinical settings and determining the cost-efficiency of these strategies; and 2) to serve as a mentor for medical trainees (medical students, residents, and fellows) and junior faculty members pursuing patient-oriented alcohol research activities and careers. His long-term career objectives are: 1) to apply his research skills to collaborative care models for improving quality of care and health outcomes for patients with unhealthy alcohol use, 2) to apply his expertise in cost-effectiveness methodology to analysis of collaborative care models and to new emerging alcohol screening methods and treatments, and 3) to be an institutional leader in the promotion of patient-oriented alcohol research and education at the University of Pittsburgh. The candidate's patient-oriented research will be conducted in two phases. During Phase I (Years 1-3), he will direct a patient-oriented study to measure patient and societal utilities and quality of life for a range of alcohol problems. In Phase II (Years 3-5), he will expand his research program to develop and test collaborative care interventions for improving quality of care and health outcomes for primary care patients with unhealthy alcohol use and to apply cost-effectiveness methodology to analysis of collaborative care models. In both phases, medical trainees and junior faculty mentored by the candidate will be integrated into the candidate's research activities. Over the course of the award, the candidate will mentor six medical students and residents, four clinical research fellows, and five junior faculty members in patient-oriented alcohol research. Research training and education experiences, tailored to the level of the mentee, will include a mentored patient-oriented research project, participation in a weekly journal club, weekly research seminars, and year-round graduate-level coursework. The proposed research and mentoring programs will be conducted at the University of Pittsburgh, which has a strong institutional commitment to the professional development of the candidate and a mission to support patient-oriented research activities by faculty members throughout its schools of the health sciences. These schools provide substantial clinical research training and education programs, including a extramurally funded General Internal Medicine Fellowship Program directed by the candidate, and the University of Pittsburgh Clinical and Translational Science Institute (CTSI).